The Dangers of Self Diagnosis

In this day and age of limited time with doctors coupled with ample opportunity to google anything, the temptation for people to reach their own conclusions about their illness is strong. In this piece, I will describe when self-diagnosis is dangerous, and what you might know overtly about this danger. Here are a few truths to consider and how self-diagnosis affects this.

When you self-diagnose, you are essentially assuming that you know the subtleties that diagnosis constitutes. This can be very dangerous, as people who assume that they can surmise what is going on with themselves may miss the nuances of diagnosis. For example, people with mood swings often think that they have manic-depressive illness or bipolar disorder. However, mood swings are a symptom that can be a part of many different clinical scenarios: borderline personality disorder and major depression being two examples of other diagnoses. The clinician can help you discern whether you swing from normal to down or down to up, and by considering how long the mood swings last, the clinician can make the appropriate diagnosis. Here, the danger is that you may misdirect the clinician or even yourself.

One of the greatest dangers of self diagnosis in psychological syndromes, is that you may miss a medical disease that masquerades as a psychiatric syndrome. Thus, if you have panic disorder, you may miss the diagnosis of hyperthyroidism or an irregular heart beat. Even more serious is the fact that some brain tumors may present with changes in personality or psychosis or even depression. If you assume you have depression and treat it with an over-the-counter preparation, you may completely miss a medical syndrome. Even if you do not want conventional treatment for depression, you may want conventional treatment for a brain tumor.

Self-diagnosis also undermines the role of the doctor-which is not the best way to start the relationship. While doctors are generally very enthusiastic about getting packaged information, it would help if you actually trusted your doctor. If your doctor is someone whom you cannot trust, then think again about why you see this doctor. Your doctor should respect your opinion, but the discussion should be an active one. If you doubt the doctor's diagnosis, tell him or her that you do and say why. This is much better than silently diagnosing your own syndrome.

Then there is the fact that we can know and see ourselves, but sometimes, we need a mirror to see ourselves more clearly. The doctor is that mirror. By self-diagnosing, you may be missing something that you cannot see. For example, you may be overwhelmed by anxiety and think that you have an anxiety disorder. The anxiety disorder may be covering up a major depressive disorder. Approximately 2/3 of people who present to outpatient clinics with anxiety have depression as well. In general, when two or more syndromes occur in the same person, we call this comorbidity. When people self-diagnose, they often miss the comorbidity that exists.

Another danger of self diagnosis is that you may think that there is more wrong with you than there actually is. For example, if you had insomnia, inattention and depression, you may believe that you have a sleep disorder, ADD and major depression. However, major depression can account for all of these symptoms. Thus, you may make things worse by worrying more as well.

Self-diagnosis is also a problem when you are in a state of denial about your symptoms. You may think that you have generalized body aches that started when your mood got worse, but a doctor may elect to do an EKG for chest pain that reveals possible coronary artery disease. You may have been trying to avoid the chest pain or you may have minimized this.

Lastly, there are certain syndromes that may not seem like problems to you even though they are very disruptive to your life. For example, with delusional disorder people do not think that they are delusional and because they are not overtly psychotic, they may not think to report paranoid symptoms that add up to delusional disorder. Also, many personality disorders are not spontaneously reported since they are usually problematic to other people.

Thus, self-diagnosis can have tremendous negative repercussions on the patient. For this reason, while reading is helpful and informative, it is always best to discuss your impressions with a doctor before you decide on the treatment you want.

First of all, Doctors have an appalling track record of blaming the victim - remember hysterical paralysis (MS), Polio, Lupus, CFS, Tourettes etc. Many people with these conditions were and some still are labelled and tossed into the Somatoform Disorders wastebasket. The proposed changes for DSM-V do not improve this. When I first sought treatment for what was eventually CFS (ME if you actually use ICD10) it took me 7 doctors over 5 years to find someone willing to refer me for diagnosis. I was referred to an Immunologist involved in the Australian research on CFS at that time whose words were "I do usually recommend self-diagnosis, but you're right". I have heard this story a thousand times (literally) in online forums and community support groups. So whil experts tell me "don't self diagnose", my experience tells me sometimes you have to. That means that if your reasearch offers a reasonable alternative hypothesis, it may be wise too pursue it to the end. Of course that may be difficult - you MAY have a somatoform or delusional disorder. I think a good Doc, counsellor or psych can help by supporting the client in their search for understanding of the ""mystery illness", while also investigating "what if we don't find an answer?" and find a way for them to start living now as much as they can.

So I agree that hypotheses and symptoms need to be discussed with a Doc, but it needs to be an openminded, supportive and inquisitve Doc. If not, find a new one.

Although you frame your response as a disagreement, I feel very much in agreement with you. I think we both agree that discussion with a good doctor is preferable to self-diagnosis without any discussion at all.

Doctors do make mistakes (even when they are well-intended) and when in doubt, a second opinion (or 3rd, 4th or 5th) can be very helpful until you are satisfied.

CFS also has a very high degree of comorbidity with a variety of medical and psychological illnesses/conditions/disabilities and talking to a doctor who knows enough to look for these comorbidities and treat them is also important, i think.

Self diagnosing isn't optimal for us patients. Unfortunatly, I've had to do just that. I have all the medical apps for the android phone and I research each and every drug and their side effects.

I'm complex diagnosed by a doctor and have ADD, Major Depression, Bipolar II, and Temporal Lobe Epilepsy (left side).

My biggest challenge working with psychiatrists has been they don't always listen and some make ignorant comments when I wanted to stop Seroquel because of proven weight gain. I was 160 and a runner, once the mood stabilizers and antipsychotics stared six years ago. I am nowhere near the person I used to be. I weigh 217 now, had a pulmonary embolism, now have thyroiditits.

The only drug keeping me working in a high level job is Keppra Vyvanse, Temazpam and a small dose of lorazepam. But my last pdoc knew better and after hearing some symptoms from my therapist rather than talk to me about his concerns sent me an email to stop Vyvase now. Really? 70mg come off cold turkey? While I am working on the biggest project of my career. So I found a new doctor and I told him what happened and asked if he treat bipolar and ADD medically. If he cannot let me know now so I can find someone that appreciates evidence. Evidence that Vyvanse has been my hero is being promoted to Director, finally studied for and passed on certification. I have one more part left and then I'll have two certifications. No longer was I that girl that would sit and spin at work and never get anything done.

I've accomplished so much with Vyvase on one hadn but on the antipsychotic side I've suffered badly with this weight gain. I have major body image issues and may have to resign from this job if I can't get a psychiatrist that is interested in working in my best interest. Taking away the one drug that gets me to work everyday is reckless. I'm off topic but on your side I validate those concerns that you have about self diagnosing, I think its a sign that psychiatry is failing most of us. I've been hospitalized twice I've seen other people who had problems sure but have so many more problems now.

I believe a person should be very involved in both the diagnosis and treatment phases. When I say involved I do not mean that a person should self diagnose or design their own treatment regime. I mean a person should respectfully question AND RESEARCH any diagnosis, treatment plan, dosages, types, reasons, side effects, risks-rewards etc. Doctor's are learned but are human and can make mistakes maybe not often and some maybe not ever but with patients active involvement it can help assure an error does not occur.

I'll start off by admitting that I don't trust doctors one bit due to the following experiences:
-forced through extremely painful (and psychologically damaging) treatments that were later proven unnecessary without anesthesia from age 2-6.
-have to explain my physical disability to doctors it's so rare, and what it's called is outdated and confused with a related condition. (Klippel Trenaunay vs. KT Weber, which basically means the KT is in the face.)
-in a routine colonoscopy, doctors tore a hole in my colon. When I complained about pain, they turned me away for an entire week, claiming it was post-op pain. Midnight one week later, I came in with peritonitis 1 inch from my lungs. An hour more and it'd have killed me.
-when speaking with many PD, I told them my brother hit me. Instead of calling this physical abuse, they called it sibling rivalry.
-when I brought up concerns about being mentally ill, PD's told me I couldn't possibly be mentally ill and used outdated tests on me.

I refuse to believe that all of these were isolated incidents, and thusly, do not trust any doctor.

I've been professionally diagnosed with every condition I've self-diagnosed first.

It's poor form to place doctors and patients in opposition like this. I've had enough doctors ignore me when I describe symptoms or dismiss them as things they aren't, so stuff goes untreated or ignored, or even better yet doctors who refuse to let me describe how much pain I'm in and how it affects me and then tell me that it's not really as bad as I think it is.

I am the primary participant in my own health care, so I am pretty invested in trying to get things identified and taken care of. I am not simply a passive object for medical professionals to examine and diagnose.

Interesting, isn't it, the irony of the comments which actually prove the Doctor's warnings. It's because of the illnesses that the writers are unable to accept the Doctor's comments. It is sometimes called being a bit thick and extremely selfish but heh ho let's hope they can be cured.

I think doctors and patients need to work together. It can be helpful to research before or after seeing a doctor, to at least give you some idea as to what's going on, so long as that is not used as the last word - and nor should one doctor's opinion be the last word. Since I am on a 6-year wait list for a doctor, some sort of idea as to what's going on and how to cope with it is better than none and I've made a lot of progress by that alone.

I definitely label those conditions as something to get diagnosed for sure once that appointment finally comes around, but for now, my option is to tackle it as if it's real. I would rather effectively use a light box every winter for Seasonal Affective Disorder I haven't officially been diagnosed with, than suffer through another winter with all the symptoms of SAD. Again, it could be other things - Hypothyroidism, for example - but for now, this is the best option.

But an unbiased opinion never hurts because, as you said, they may know things you don't - and vice versa. Ultimately, I agree people need to tread in the waters of self-diagnosis with great caution, because as I know, you can start to see things that aren't there and things can start to look wrong when, in reality, there's nothing there. If you're going to self-diagnose, you have to go into it knowing you can be completely and utterly wrong.

Re: those who distrust doctors . . . Not all doctors are bad, but as my mother says, "Someone had to graduate at the bottom of the class." There are going to be not-so-great doctors out there, because they're human and they make mistakes. It's inevitable. But there ARE good ones. And they will make mistakes, too.

First of all, Doctors usually misdiagnose stuff, when they don't allow the patient to fully explain their symptoms and stuff. and they also misdiagnose stuff on purpose because they want more money from the patient. and with the help of webmd.com, and pharmaceutical be available online. like internationally. as long you are careful with the dosage you should be fine. Self-diagnosing yourself, but if you have an allergic reaction, then get a conventional treatment. And people can barely afford insurance(life, health, dental) all of these require a deductible to be paid before the insurance company would pay anything in the first place. and the dental insurance.deductibles required to me paid, each year while other life insurance or health insurances don't need to be paid each year.